Threshold Services is committed to evidence-based practice; that is, the use of recovery practices that have been shown to produce positive outcomes through a body of research - practices that enjoy empirical support. Evidence-based practices offered at Threshold Services include: Integrated Dual Disorders Treatment, Supported Employment, Illness Management and Recovery, Family Psychoeduation, Motivational Interviewing, and Dialectical Behavior Therapy.

One example of an evidence-based practice: Integrated Dual Disorders Treatment

All Threshold Services programs have attained evidence-based dual disorders treatment capability. All teams serve people with mental illness only as well as people with co-occurring mental illness and substance use disorders. The specialized IDDT team serves only people with co-occurring (dual) disorders. Research has shown conclusively that the most effective treatment for co-occurring mental illness and substance use disorders is integrated; that is, treatment is provided for both disorders by the same people in the same place at the same time. People with dual disorders can achieve recovery. Building a satisfying and meaningful life without drugs or alcohol is possible, but it requires time, support, education, courage and new skills.

• Treatment is tailored to the individual’s stage of change, from pre-contemplation (when a person is not motivated to change) through contemplation, preparation, action and maintenance. The focus of treatment is different for each stage of change.
• Relapses do happen, but most people are able to recover from relapses relatively quickly and get back to where they were before they relapsed.
• Families and clinicians cannot force people to give up alcohol and drugs. Family and other supporters can help by providing support and hope, but recovery must be a person’s own choice. It may take a long time for some people to achieve recovery.
• People with dual disorders can learn from peers who are in recovery. Some may benefit from self-help groups such as Alcoholics Anonymous, Narcotics Anonymous, and Dual Recovery Anonymous.

Another example of an evidence-based practice: Dialectical Behavior Therapy

Threshold Services offers Dialectical Behavior Therapy (DBT) at both its Rockville and Silver Spring Outpatient Mental Health Centers. DBT is intended for people whose emotions create major problems in their lives, and who express them in destructive ways. DBT consists of weekly individual therapy and a weekly skills group, which emphasize: mindfulness in everyday living, relating to others effectively, regulating emotions, and tolerating distressing feelings.

Motivational Interviewing

All Threshold Services staff members are trained in motivational interviewing, which prepares people for change. People do not change their behavior for the better – ceasing to drink, drug, smoke, overeat, or avoid necessary medications, for example - simply because it is logical to do so or because someone tells them that they should. When one is told that s/he should change when s/he is not ready to change, s/he tends to explain why s/he should not or cannot change, and becomes more dug in than ever. Motivational interviewing is a skillful approach to questioning and conversation that helps people develop a discrepancy between what they want and what they are doing. It fosters “change talk”; that is, it elicits the person’s own reasons for and advantages of change. It helps people to become ready, willing and able to change in order to get more of what they want out of life.

Family Psychoeducation (FPE)

FPE is an evidence based practice that focuses on problem solving and communication between clients and their families or other supports. The service is provided as a multi family group where clients and their family members meet twice a month to discuss any problems or concerns that arise and learn skills to resolve these issues. The groups are led by two trained facilitators who emphasize education and skills training. The education promotes understanding of mental illness and/or substance use, especially identifying early warning signs and defining the recovery process. Group members share achievements and challenges that promote support and guidance from the group. Group members share ideas and experiences that encourage positive ways to re-connect with loved ones. Research reports reductions in relapse by as much as 50% for people with schizophrenia or related thought disorders. In addition, the clients functioning in the community improves steadily, especially for employment and family members have less stress, improved coping skills and greater satisfaction with caretaking. Currently there is an active FPE group for clients with Mood Disorders such as Bipolar Disorder, Depression, or Schizoaffective Disorder. If you are interested in this group, please contact Clinic Director Dennis Blair at 301-838-4101.

And one more: Illness Management and Recovery

Our Renaissance program and our group homes offer Illness Management and Recovery (IMR) groups. IMR consists of a series of weekly sessions in which people develop personalized strategies for managing their illness and moving forward in their lives. In the sessions, staff members work collaboratively with participants, offering information, strategies and skills that people can use to further their own recovery. There is a strong emphasis on helping people set and pursue personal goals and helping them put strategies into action in their everyday lives.